Words fail: Lesion-symptom mapping of errors of omission in post-stroke aphasia

Impaired object naming is a core deficit in post-stroke aphasia, which can manifest as errors of commission – producing an incorrect word or a non-word – or as errors of omission – failing to attempt to name the object. Detailed behavioural, computational, and neurological investigations of errors of commission have played a key role in the development of neurocognitive models of word production. In contrast, the neurocognitive basis of omission errors is radically underspecified despite being a prevalent phenomenon in aphasia and other populations. The prevalence of omission errors makes their neurocognitive basis important for characterizing an individual's deficits and, ideally, for personalizing treatment and evaluating treatment outcomes. This study leveraged established relationships between lesion location and errors of commission to investigate omission errors in picture naming. Omission error rates from the Philadelphia Naming Test for 123 individuals with post-stroke aphasia were analysed using support vector regression lesion-symptom mapping. Omission errors were most strongly associated with left frontal and mid-anterior temporal lobe lesions. Computational model analysis further showed that omission errors were positively associated with impaired semantically driven lexical retrieval rather than phonological retrieval. These results suggest that errors of omission in aphasia predominantly arise from lexical–semantic deficits in word retrieval and selection from a competitor set.     

Spoken syntax in children with acquired unilateral hemisphere lesions

The spoken syntax of eight left hemisphere lesioned and eight right hemisphere lesioned children were compared to matched controls. The children's lesions were acquired between 0.08 and 6.17 years of age (mean = 1.33 years), and at the time of testing they were between 1.67 and 8.15 years of age (mean = 4.19). Based on analyses of spontaneous language samples, left hemisphere lesioned subjects performed more poorly than did their controls on most measures of simple and complex sentence structure. In contrast right lesioned subjects performed similarly to their controls on these measures, except for a tendency to make more errors in simple sentence structures. These findings provide further evidence that the left and right hemispheres are not comparable in supporting syntactic abilities.     

Unilateral brain lesions in childhood: performance on the Revised Token Test

Comprehension of connected language as assessed by the Revised Token Test (RTT) was studied in 17 children with left hemisphere lesions (LL) and 11 with right hemisphere lesions (RL). LL children's significantly lower performance on several subtests than left controls (LC) matched by age, sex, race, and social class appeared to be related to the memory demands of these subtests rather than the limited syntactic elements assessed by the RTT. LL subjects requested significantly more command repetitions than control or RL subjects and when a repetition was not requested LL subjects often responded with immediacy. Although RL children tended to perform lower than right matched controls (RC), these differences were not significant nor readily related to either the memory or specific linguistic structures assessed. RL subjects required fewer command repetitions than LL subjects and exhibited a significantly greater frequency of immediate responses than controls or LL subjects. While based on few children, a trend for LL children with retrorolandic lesions to perform more poorly than those with left prerolandic lesions was suggested. No systematic difference in performance was apparent for children with left cortical vs. left subcortical lesions or among discrete sites of lesions within the right hemisphere. Children with left lesions prior to 1 year of age performed no better and, in several instances, significantly poorer than LL patients sustaining lesions after 1 year of age. Among RL subjects, those sustaining lesions after 1 year of age had greater difficulty than those with lesion onset before 1 year of age, especially on linguistic elements which seemed to be dependent upon visual spatial properties. Further studies are needed to evaluate the comprehension of more complex linguistic structures among children with unilateral brain lesions as well as to study the role of more basic factors such as memory and attention in explaining the present findings.     

Semantic Degradation and Lexical Access in Age-Related Naming Failures

This study investigated the impaired lexical access and semantic degradation hypotheses as two potential explanations of naming failures in normal aging. Naming responses on the Boston Naming Test (BNT) and Action Naming Test (ANT) were analyzed across three test sessions for 39 adults from three age groups (50s, 60s, and 70s). Failures to name before and after cues were classified as either impaired access if failures occurred at an earlier test session followed by successful naming at a later test session or semantic degradation if naming was successful at an earlier test session followed by failures at a later test session. The results indicated that on both the BNT and ANT all age groups produced more naming failures attributed to impaired access than to semantic degradation. However, for object naming, the failures showed significantly more semantic degradation for people in their 70s compared to the younger age groups. By contrast, for action naming, semantic degradation was negligible, possibly masked by a ceiling effect, and the only age-difference result that approached significance indicated that adults in their 70s produced more naming failures attributed to impaired access than adults in their 50s.     

Fluency of conversational speech in children with unilateral brain lesions

The spontaneous conversational speech of 20 children with unilateral left hemisphere lesions and 13 with right lesions was compared to normally developing peers matched by age, sex, race, and social class for instances of stuttering type nonfluencies, normal nonfluencies, and rate of speech. Both left and right lesioned children provided quantitatively more and qualitatively different patterns of nonfluencies than their neurologically normal peers. Left and right lesioned children produced more stuttering types of nonfluencies than their controls, but neither lesioned group produced a greater number of normal nonfluencies than controls. Left lesioned children also had a slower rate of speech as measured by number of syllables per second during either stuttered or fluent speech. Considerable variability was observed among lesioned children. Implications for neurogenic theories of developmental fluency disorders are discussed.     

Learning to divide the labor: an account of deficits in light and heavy verb production

Theories of sentence production that involve a convergence of activation from conceptual‐semantic and syntactic‐sequential units inspired a connectionist model that was trained to produce simple sentences. The model used a learning algorithm that resulted in a sharing of responsibility (or “division of labor”) between syntactic and semantic inputs for lexical activation according to their predictive power. Semantically rich, or “heavy”, verbs in the model came to rely on semantic cues more than on syntactic cues, whereas semantically impoverished, or “light”, verbs relied more on syntactic cues. When the syntactic and semantic inputs were lesioned, the model exhibited patterns of production characteristic of agrammatic and anomic aphasic patients, respectively. Anomic models tended to lose the ability to retrieve heavy verbs, whereas agrammatic models were more impaired in retrieving light verbs. These results obtained in both sentence production and single‐word naming simulations. Moreover, simulated agrammatic lexical retrieval was more impaired overall in sentences than in single‐word tasks, in agreement with the literature. The results provide a demonstration of the division‐of‐labor principle, as well as general support for the claim that connectionist learning principles can contribute to the understanding of non‐transparent neuropsychological dissociations.     

Developmental dyslexia and word retrieval deficits

Developmental dyslexics, selected on the basis of very slow naming rates on the Rapid Automatic Naming Tasks (RAN), were compared to normal readers on oral language, picture categorization, and reading tasks. Findings indicated that the dyslexics' word retrieval deficits were one symptom of a more generalized, however subtle, oral language deficit which involved both receptive and expressive oral language functioning. The dyslexics' word retrieval problem also seemed chiefly related to language processing and not to deficits in semantic memory as there were no significant differences between dyslexics and controls on a nonverbal semantic memory task (picture categorization). In naming and identifying printed words, the dyslexics appeared to rely considerably upon the "indirect" or "assembly-of-phonology" route; they were slower in naming irregularly spelled words compared to regularly spelled words and on a lexical decision task, the dyslexics were slower in making negative decisions for "pseudohomophones" (e.g., "braik") than for other matched nonwords. Results are discussed in terms of the logogen model with some consideration of a developmental model as well.     

Naming consistency in Alzheimer''s disease

Although lexical semantic deficits are postulated to play a prominent role in the anomia of Alzheimer's disease, it is unclear whether the primary disturbance is one of lexical access or one of lexical semantic loss. Response consistency on a naming task is one means of evaluating the underlying source of naming impairment. Access dysfunction usually implies variable word-finding difficulty, while a theory of lexical loss predicts that many word names would be consistently unavailable. Nineteen Alzheimer's disease patients were administered a visual confrontation naming task (the Boston Naming Test) on two occasions 6 months apart. Eighty percent of errors occurred consistently at both times; only 20% of errors occurred on only one occasion. Response consistency occurred significantly more often than expected under the assumption of no response consistency. Findings support the hypothesis that anomia in Alzheimer's disease is in part due to a loss of lexical semantic information.     

Semantic abilities in dementia of the Alzheimer type. 1. Lexical semantics

The lexical semantic abilities of 18 Alzheimer patients were investigated using confrontation naming tasks (including both visual and tactile naming tests) and compared to those of a group of institutionalized, nonneurologically impaired control subjects matched for age, sex, and educational level. The Alzheimer patients produced a greater number of naming errors than the control subjects. The errors made by subjects during the naming tasks were analyzed according to a set of 16 error response types. The Alzheimer patients' response patterns suggest that they do recognize objects which they are unable to name and are able to identify the semantic class to which the target belongs, but cannot provide the lexeme corresponding to the correct individual class member. The results support a semantic network disruption rather than a visual perceptual deficit as the basis of the naming disturbance observed in Alzheimer patients.     

Verbal Fluency,Semantics, Context and Symptom Complexes in Schizophrenia

Lexical-semantic access and retrieval was examined in 15 adults diagnosed with schizophrenia and matched controls. This study extends the literature through the inclusion of multiple examinations of lexical-semantic production within the same patient group and through correlating performance on these tasks with various positive and negative clinical symptoms. On tasks of verbal fluency, meaning generation, sentence production using contextual information and confrontation naming, participants with schizophrenia made significantly more semantic errors on naming tasks; produced fewer meanings for homophones; produced fewer items on semantic, phonological, cued and switching fluency tasks; and produced more errors on sentence production tasks when compared to healthy controls. Significant correlations were also observed between ratings of psychomotor poverty and measures of semantic production and mental inflexibility. This study has provided additional evidence for deficits in lexical-semantic retrieval which are not due to underlying semantic store degradation, do not involve phonological based retrieval, and at the level of sentence generation appear to vary as a function of the contextual constraints provided.     

A fMRI study of word retrieval in aphasia

The neural mechanisms underlying recovery of cognitive functions are incompletely understood. Aim of this study was to assess, using functional magnetic resonance (fMRI), the pattern of brain activity during covert word retrieval to letter and semantic cues in five aphasic patients after stroke, in order to assess the modifications of brain function which may be related to recovery. Four out of five patients had undergone language recovery, according to standard testing, after at least 6 months of rehabilitation. The cerebral activation of each patient was evaluated and compared with the activation pattern of normal controls studied with the same fMRI paradigm. In the patients, the pattern of brain activation was influenced by the site and extent of the lesion, by the degree of recovery of language, as reflected by task performance outside the scanner, and by task requirements. In the case of word retrieval to letter cues, a good performance was directly related to the activation in Broca's area, or in the right-sided homologue. On the other hand, in the case of semantic fluency, the relationship between performance level and activation was less clear-cut, because of extensive recruitment of frontal areas in patients with defective performance. These findings suggest that the performance in letter fluency is dependent on the integrity of the left inferior frontal cortex, with the participation of the homologous right hemispheric region when the left inferior frontal cortex is entirely of partially damaged. Semantic fluency, which engages the distributed network of semantic memory, is also associated with more extensive patterns of cerebral activation, which however appear to reflect retrieval effort rather than retrieval success.     

Lexical Anomia: Or the Case of the Missing Lexical Entries

This paper reports the case of an aphasic patient, EE, with a problem in word retrieval. He is consistently unable to produce specific lexical items, which tend to be items of low rated familiarity. His retrieval of these words is not aided by the provision of phonemic cues or extra time for word retrieval. His errors consist primarily of failures to respond, and the provision of semantic information without any attempt at the target. It is argued that this pattern of performance is consistent with the loss of specific lexical items from a phonological lexicon for speech production.

EE is shown to have no impairment in auditory recognition and comprehension of the lexical items that are unavailable for naming. This dissociation is problematic for theories that propose a single phonological lexicon for both word recognition and production, but is easily accounted for by separate input and output lexicons.     

Impaired word naming in right-brain-damaged right-handers: error types and time-course analyses

The purpose of this study is to search for cues that could account for the fact that right-hemisphere lesions affect word naming when the criterion for naming is semantic. The authors analyzed the errors as well as the time course of productions of 35 vascular right-brain-damaged subjects (RBD) and 20 control subjects (C) in a semantic-based word-naming task. Results show that there are no differences between groups in terms of (a) the number of errors produced and, (b) the patterns of error types. However, results also show a reduction of verbal fluency for semantic criteria in RBD-subjects present only after the first 30 seconds of production. These results indicate that reduction of word production in RBD-subjects is not the consequence of nonspecific factors such as perseveration or spontaneity, but reflects problems with the less automatized processes permitting exploration of semantic organization, either because scanning process are affected, or because the presence of a discreet semantic impairment prevents scanning from being as efficient. Given that efficient exploration of semantic knowledge is important for lexico-semantic functioning, the present results suggest that the right hemisphere contributes to some aspects of lexico-semantic processing necessary for language production.     

Support for anterior temporal involvement in semantic error production in aphasia: new evidence from VLSM

Semantic errors in aphasia (e.g., naming a horse as “dog”) frequently arise from faulty mapping of concepts onto lexical items. A recent study by our group used voxel-based lesion-symptom mapping (VLSM) methods with 64 patients with chronic aphasia to identify voxels that carry an association with semantic errors. The strongest associations were found in the left anterior temporal lobe (L-ATL), in the mid- to anterior MTG region. The absence of findings in Wernicke’s area was surprising, as were indications that ATL voxels made an essential contribution to the post-semantic stage of lexical access. In this follow-up study, we sought to validate these results by re-defining semantic errors in a manner that was less theory dependent and more consistent with prior lesion studies. As this change also increased the robustness of the dependent variable, it made it possible to perform additional statistical analyses that further refined the interpretation. The results strengthen the evidence for a causal relationship between ATL damage and lexically-based semantic errors in naming and lend confidence to the conclusion that chronic lesions in Wernicke’s area are not causally implicated in semantic error production.     

Semantic errors in a deep dyslexic

A case of a Swedish-speaking deep dyslexic is reported whose semantic paralexias appeared to result mainly from a lexical retrieval failure in oral reading. He was able to draw correct pictures of the written words for which he had simultaneously produced a semantically erroneous oral reading response. Repeated attempts to correct paralexic responses were common, indicating that the patient was often aware of the errors. His lexical retrieval problems and semantic errors extended to naming as well, and the results support Nolan and Caramazza's (1982, Brain and Language, 16, 237-264), dual-deficit model of deep dyslexia.     

Hemispheric asymmetries in the activation and monitoring of memory errors

Previous research on the lateralization of memory errors suggests that the right hemisphere's tendency to produce more memory errors than the left hemisphere reflects hemispheric differences in semantic activation. However, all prior research that has examined the lateralization of memory errors has used self-paced recognition judgments. Because activation occurs early in memory retrieval, with more time to make a decision, other memory processes, like strategic monitoring processes, may affect memory errors. By manipulating the time subjects were given to make memory decisions, this study separated the influence of automatic memory processes (activation) from strategic memory processes (monitoring) on the production of false memories. The results indicated that when retrieval was fast, the right hemisphere produced more memory errors than the left hemisphere. However, when retrieval was slow, the left hemisphere's error-proneness increased compared to the fast retrieval condition, while the right hemisphere's error-proneness remained the same. These results suggest that the right hemisphere's errors are largely due to activation, while the left hemisphere's errors are influenced by both activation and monitoring.     

汉语双字词的心理词典存储—来自发展性阅读障碍个案的证据

研究探讨了发展性阅读障碍个案S汉字命名过程选择性错误的产生机制。汉字命名、词汇判断和组词实验有三个主要发现,个案S在汉字命名过程中产生大量的选择性错误,选择性错误在复合词中发生的前后位置没有显著差异;S在词汇判断过程中,混淆词汇中两个词素的先后顺序;S对产生选择性错误的汉字组词的数量显著少于控制组,且其产生选择性错误的复合词的频率显著高于他组出的其他词汇频率。研究以Zhou&Marslen-Wilson(2000)的复合词的多水平平行结构心理词典模型为基础讨论了这些发现的理论意义,并着重分析了汉字命名过程中词素频率和词汇意义结构之间的交互作用。     

习得年龄对客体和动作图画口语命名的不同影响：ERP研究

词汇习得年龄指人们最早理解单词意义时的年龄, 已有研究发现早习得词汇的阅读反应时间短于晚习得词汇, 研究者对于词汇习得年龄效应的认知机制存在争论。本研究运用事件相关电位技术, 考察了词汇习得年龄(早与晚)对客体图画和动作图画命名的影响。研究中采用图画命名任务, 要求被试在看到图画后迅速且准确地说出图画名称。结果发现早习得名词的命名快于晚习得名词, 而早习得动词的命名却慢于晚习得动词; 习得年龄对于名词产生的影响发生在图画呈现后的250~300 ms之间, 表现为早习得名词波幅小于晚习得名词, 而习得年龄对于动词产生的影响发生在图画呈现后的200~600 ms之间, 表现为早习得动词波幅大于晚习得动词。这表明名词产生中的习得年龄效应发生在词汇选择阶段, 支持了语义假设的观点; 动词产生过程中的习得年龄效应出现在多个加工阶段, 包括了词汇选择、音韵编码和语音编码阶段, 这与动词语义的多重性及其与动作相关的脑区激活有关, 支持了网络可塑性假说的观点。     

Lexical and semantic factors influencing picture naming in aphasia

Picture naming requires early visual analysis, accessing stored structural knowledge, semantic activation, and lexical retrieval. We tested the effect of perceptual, lexical, and semantic variables on the performance of aphasics in picture naming and assessed prevalence of natural categories vs artifact dissociations. Forty-nine aphasics were asked to name 60 pictures, from three natural (animals, fruits, and vegetables) and three artificial categories (tools, furniture, and vehicles). For each item visual (drawing complexity, image agreement), semantic (prototypicality, concept familiarity) and lexical variables (word frequency, name agreement) were available. The effect of these variables showed individual differences; altogether, visual complexity had little influence, whereas lexical and semantic variables were more influential. Name agreement was most important, followed by word frequency. On a multiple single case analysis 10 patients (20%) showed a natural/artificial category dissociation. Five of the six subjects faring better with artifacts were males, and all of four patients faring better with natural categories were females. Interpretations of this finding are discussed.